VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0940800
Sex: F
Age:
State: MN

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: dizzy; felt like I was going to pass out; shaky; ringing in ears; This is a spontaneous report from a contactable nurse (patient herself). A 63-year-old non-pregnant female patient received her first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: unknown), via intramuscular route of administration on the left arm on 30Dec2020 17:00 at a single dose for COVID-19 immunization at hospital facility. The patient had no relevant medical history and no known allergies. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks, or any other medications within 2 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient reported "almost immediately, dizzy, felt like I was going to pass out, shaky, and ringing in ears" on 30Dec2020 17:00. Events were reported as non-serious but resulted in visit to the Emergency room/department or urgent care. Ondansetron (ZOFRAN) was given as treatment for nausea and meclizine. The outcome of the events was not recovered. Since the vaccination, the patient had not been tested for COVID-19. Information on the lot/batch number has been requested.; Sender's Comments: The Company cannot completely exclude the possible causality between the reported "dizzy, felt like I was going to pass out, shaky, and ringing in ears" and the administration of COVID 19 vaccine, BNT162B2, based on the plausible temporal association. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RA, IEC, as appropriate.

Other Meds:

Current Illness:

ID: 0940801
Sex: F
Age:
State: CA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Test Date: 20210106; Test Name: Blood pressure; Result Unstructured Data: Test Result:226/97; Comments: 10:30 BP elevated; Test Date: 20210106; Test Name: Blood pressure; Result Unstructured Data: Test Result:continues to be elevated; Test Date: 20210106; Test Name: Blood pressure; Result Unstructured Data: Test Result:slowly came down; Test Date: 20210107; Test Name: Blood pressure; Result Unstructured Data: Test Result:137/72; Comments: BP normal; Test Date: 20210106; Test Name: CT scan; Result Unstructured Data: Test Result:normal; Test Date: 20210106; Test Name: Heart rate; Result Unstructured Data: Test Result:normal; Test Date: 20210106; Test Name: lab test; Result Unstructured Data: Test Result:normal; Test Date: 20210106; Test Name: Respiratory rate; Result Unstructured Data: Test Result:normal; Test Date: 20210106; Test Name: vital signs; Result Unstructured Data: Test Result:no fever

Allergies:

Symptoms: felt flushed; BP elevated 226/97; dull occipital headache/dull headache; This is a spontaneous report from a contactable other HCP (patient). A 64-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EL1284; expiration date not provided) via an unspecified route of administration (vaccination location: left arm) on 06Jan2021 09:30 at SINGLE DOSE for COVID-19 immunisation. Medical history was reported as 'none'. It was also reported that patient didn't receive any other vaccines within 4 weeks prior to the COVID vaccine, and prior to vaccination, the patient was not diagnosed with COVID. The patient has no allergies to medications, food, or other products (no known allergies). The patient's concomitant medications were not reported. The patient previously took bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EH9899; expiration date not provided), via an unspecified route of administration (vaccination location: left arm) on 18Dec2020 18:00 at SINGLE DOSE for COVID-19 immunisation. It was reported that patient received second dose of Pfizer Covid vaccine on 06Jan2021 at 09:30 am. One hour after the 2nd dose (10:30 am), patient experienced dull occipital headache. Patient took paracetamol (TYLENOL). At 10:45 am, patient felt flushed. The nurse took patient's vital signs and noted no fever, normal heart rate and respiratory rate. BP elevated 226/97 (reported at 10:30, no unit provided; normal BP: 130's/80's). At 12:45, patient was taken to ED. CT scan and lab work were reported as all normal. BP continues to be elevated. Amlodipine (NORVASC) 10 mg was given at 17:00. BP slowly came down. Twenty-four hours later, BP was normal at 137/72 (no unit provided). No additional medication taken. It was reported that patient continues to have dull headache. No arm soreness or other symptoms. It was also reported that since the vaccination, the patient has not been tested for COVID-19. Outcome of the events 'BP elevated 226/97' and 'felt flushed' was recovering, outcome of the event 'dull occipital headache/dull headache' was not recovered.; Sender's Comments: Based on the compatible temporal association and in absence of strong confounding factors, the Company considers the reported event blood pressure increased is possibly related to vaccination with BNT162B2. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0940804
Sex: F
Age: 41
State: TX

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Penicillin

Symptoms: Arm Sore, fatigue, weak, body aches, not feeling well

Other Meds: B12, Celebrex, Celexa, Gabapentin, Naltrexone, Methocarbamol, Diamox, Prilosec, Sulcrafate,

Current Illness: N/A

ID: 0940805
Sex: F
Age:
State: PA

Vax Date: 12/24/2020
Onset Date: 12/01/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash/getting this rash on my face and everywhere/rash and it is breaking out her face and now it is all over; a lot of muscle pain; could not sleep; This is a spontaneous report from a contactable consumer (patient). A 27-year-old female patient received first dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscular in left deltoid on 24Dec2020 09:30 at single dose for preventative. Medical history included none. There were no concomitant medications. The patient previously took influenza vaccine (FLU) for immunization and experienced sick (Flu shot if it contains egg she gets really sick). Patient reported experiencing a rash 2 weeks on 06Jan2021 after getting her first dose of the vaccine. Caller stated ''I'm concerned because I'm getting this rash on my face and everywhere and I'm due for my booster on 13Jan2021." Caller questioned if others had reported this. She had a lot of muscle pain on 24Dec2020 and could not sleep from the pain in Dec2020. Reports the pain is gone now and lasted till 28Dec2020. She has a rash and it is breaking out her face and now it is all over. States nothing has changed and the vaccine was the only new thing. States the rash started two weeks since she got the vaccine. Vaccination facility type was Hospital. Vaccine administered at military facility was No. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. AE not require a visit to emergency room. Therapeutic measures were taken as a result of rash/getting this rash on my face and everywhere/rash and it is breaking out her face and now it is all over (Doctor ordered steroids for her today she is a CNA). The outcome of the event a lot of muscle pain was recovered on 28Dec2020. The outcome of the event rash/getting this rash on my face and everywhere/rash and it is breaking out her face and now it is all over was not recovered. The outcome of the event could not sleep was unknown. Information about lot/batch has been requested.

Other Meds:

Current Illness:

ID: 0940806
Sex: F
Age:
State:

Vax Date: 01/04/2021
Onset Date: 01/01/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Test Date: 202101; Test Name: blood sugar; Result Unstructured Data: Test Result:high; Test Date: 202101; Test Name: blood pressure; Result Unstructured Data: Test Result:lowered

Allergies:

Symptoms: passed out; blood pressure was lowered; blood sugar high; weakened; feeling tired and her legs are heavy; feeling tired and her legs are heavy; This is a spontaneous report from a contactable consumer (Patient's Mother). A 23-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 04Jan2021 Monday at single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced passed out 12 hours post injection (Jan2021). She specified that her daughter was therefore brought to hospital by ambulance. She continued explaining that her blood pressure was lowered, her blood sugar high and that she was weakened (Jan2021). On 08Jan2021, "day 4", she said that her daughter had been feeling tired and her legs are heavy (Jan2021). The event outcome was unknown. She then asked if those side effects were experienced after the vaccine. It was not reported as serious. Information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 0940808
Sex: F
Age: 37
State: AZ

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Exhaustion-Medium, Systemic: Fainting-Medium, Systemic: muscle tightness and weakness-Medium

Other Meds:

Current Illness:

ID: 0940809
Sex: M
Age:
State: NY

Vax Date: 12/26/2020
Onset Date: 12/31/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Test Name: sugar; Result Unstructured Data: Test Result:was up a little bit; Test Date: 20210104; Test Name: blood work; Result Unstructured Data: Test Result:Unknown results

Allergies:

Symptoms: left side will blur; Left side of face was sagging/ water leaking out of mouth/Progressive weakness on left side of face/ Swelling on lower left mandible/ diagnosed with Bell's Palsy.; Eye tearing; This is a spontaneous report from a contactable nurse who reported for himself. A 61-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Batch/lot number: EK5780) in left arm on 26Dec2020 at 08:30 at single dose for covid-19 immunisation (worked in surgical ICU and was over 61 years old). Medical history included Pre-diabetic. Family history included: mother died; mother's side had colon cancer and grandparents and uncles had cardiovascular diseases.Concomitant medication included exenatide (BYDUREON), amlodipine besilate (NORVASC), omeprazole (PROTONIX), hydrochlorothiazide, lisinopril and pneumococcal vaccine on 08Dec2020 and tetanus vaccine on 08Dec2020. It was reported that on 31Dec2020 at 07:30, the patient had eye tearing and water leaking out of mouth, left side of face was sagging, swelling on lower left mandible (eye tearing was first, as reported); on 31Dec2020 he also experienced progressive weakness on left side of face; on 02Jan2021 the patient was diagnosed with Bell's Palsy. Then on an unknown date, left side will blur occurred. All events required emergency room visit and physician office visit. Diagnosis of Bell's Palsy and event eye tearing were serious per disability; left side will blur was non serious. Patient described the events as follows: on 31Dec2020 he was brushing teeth and noticed the water was going everywhere. Left side of face was sagging, noticed some swelling and thought it was from a bug bite. He wasn't sure if it was a stroke or not. In the morning of 01Jan2021 noticed it was progressively causing a problem. Days before noticed tearing of left eye (as reported). On 31Dec2020 before midnight, something felt wrong. He saw four cases on clinical trial with similar side effects (he clarified he had no patient information for the four patients mentioned with similar side effects from Pfizer Clinical trial. He saw this information from a article; stated four from Pfizer and Moderna). In the morning of 02Jan202, he went to Emergency Room (ER) and was diagnosed with Bells Palsy. He was given prednisone 20mg to take 3 times by mouth every day for 5 days, tetracycline 100mg, at 1 capsule by mouth twice a day for 10 days and methylprednisolone (SOLU MEDROL; Lot: 9945776;Exp: Nov2021) 4mg dose pack, started with 6 tablets first day. It was told by doctor it might cause tick problems. He was waiting for results. On 04Jan2021 went to family doctor and more blood work was taken. Because he was taking prednisone, noticed his sugar was up a little bit (date unspecified). It was prescribed Glitizide extended release, 2.5mg one tablet twice a day with breakfast. Patient was checking sugar every 6 hours. It was also prescribed Acyclovir 400mg one tablet orally five times per day for 10 days. 08Jan2021 is last day of prednisone 5 day dose and will follow up with methylprednisolone tablets. Patient had an appointment with a neurologist on 13Jan2021. Patient was still having symptoms. It was really hard for him. Not hard to swallow. Face was still drooping. Eyes were still tearing. Could not work with eyes tearing all of the time. Needed to be alert. When driving, had to focus on the right side because his left side will blur. He had to chew only on the right side because food will be left behind in between his cheeks and gums. If he drank through a straw, he had to cover the left side of his lips so he was able to suck out fluids. He thought symptoms were progressively getting worse, he didn't see much improvement. He clarified swelling was on lower part of mandible on left side. It was slightly bigger than right. When looking at face, the lines on his forehead on the left side were down. If he smiled he cannot raise his left eye brow, when before the COVID-19 vaccine he could. Noticed left side of nose was lower than the right. Cannot raise left side of lips. Outcome of the event Eyes tearing and Bell's Palsy was not recovered; outcome of the other event was unknown. Information on the batch number has been requested.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of Bell's palsy, Lacrimation increased and vision blurred due to temporal relationship. However, the Bell's palsy may likely possibly represent concurrent medical condition in this patient. There is limited information provided in this report. Additional information is needed to better assess the case, including complete medical history, diagnostics including head CT/MRI and viral serologies, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: BYDUREON; NORVASC; PROTONIX [OMEPRAZOLE]; ;

Current Illness:

ID: 0940810
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Bell's Palsy; This is a spontaneous report from a contactable nurse. A 33-year-old male patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The reporter reported a patient developed Bell's Palsy after receiving the first dose of the vaccine. This patient was a physician, the reporter stated that the patient was scheduled to receive the second dose on Monday (unspecified date) and questioned if he should or should not get the second dose. The outcome of the event was unknown. Information on the lot/batch number has been requested.; Sender's Comments: Based on temporal association, the causal relationship between bnt162b2 and the event facial paralysis cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0940811
Sex: F
Age:
State: CO

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: hearing loss; ringing and pulsating in her ears; Chills; Headache; This is a spontaneous report from a contactable consumer (patient). A 36-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EK9231), via an unspecified route of administration in in the left arm on 04Jan2021 at single dose for covid-19 immunization. Medical history included ongoing acid reflux. The patient had no concomitant medications. The patient previous received the flu shot. The patient experienced hearing loss, ringing and pulsating in her ears on 05Jan2021, headache on 04Jan2021, chills on 05Jan2021. Treatment was none. She had the vaccine on Monday at work and some of the symptoms that she has had have not resolved. She was having ringing in her ears and hearing loss. Went to see them and had her ears looked at. Everything was normal. Got the vaccine on 04Jan2021. Ringing in ears and hearing loss: Had been very consistent with no improvement. If anything, it had worsened. She was going to re-contact her doctor. She was also going to ask, should she go on Prednisone or something. She was worried she was going to lose her hearing. Her doctor said that a hearing test may need to be done. History: Takes one medication that she has been taking for years. She has never had an adverse event to any vaccine before. She got the flu shot every year. She was expecting the chills and headache, but they resolved fast. The next vaccine was 25Jan2021, the patient was asked whether she should get the second dose. The outcome of events for hearing loss, ringing and pulsating in her ears was not resolved, for headache and chills was resolved on 06Jan2021.

Other Meds:

Current Illness: Acid reflux (esophageal)

ID: 0940812
Sex: F
Age: 26
State: PA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: -Pt received COVID19 Moderna Vaccine today around 10:30 on 01/08/2021. -Pt has type 1 diabetes. -Just before and after vaccine was given, her sugars climbed to 299 (she has a monitor that checks constantly). Her normal sugars range from 120-150. -She reports that reaction is normal for her in stressful situations. Patient has history of mid anxiety. No hx of allegies. -She gave herself 1.5 units of insulin. -She denied blurry vision, headache, dizziness, polydipsia polyuria, polyphagia, headache, chest pain, shortness of breath, difficulty breathing, rash, itchiness, nausea, vomiting, abdominal pain, fatigue. -I evaluated patient. -Vitals normal. -After a couple of hours, her sugars were back to normal. -Pt was observed for multiple hours, as she was also simultaneously working in the vaccine clinic. -Pt discharged after 4-5 hours.

Other Meds: insulin - unsure of dosage (type 1 diabetic)

Current Illness: n/a

ID: 0940813
Sex: F
Age:
State: NJ

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Test Date: 20210102; Test Name: blood pressure; Result Unstructured Data: Test Result:dropped to 70/40; Test Name: oxygen levels; Result Unstructured Data: Test Result:normal; Test Date: 202012; Test Name: COVID; Result Unstructured Data: Test Result:positive; Comments: testing positive in mid December to COVID and being declare Covid free on 30Dec.; Test Name: vitals; Result Unstructured Data: Test Result:normal; Test Name: vitals; Result Unstructured Data: Test Result:improved significantly

Allergies:

Symptoms: she was dying as her blood pressure dropped to 70/40 and to come for a last visit; This is a spontaneous report from a contactable consumer. A 100-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 02Jan2021 at single dose for COVID-19 immunization. Medical history included COVID in Dec2020, urinary tract infection (UTI), dehydration and Covid sickness (vomiting) (was treated earlier in month for UTI and dehydration from the Covid sickness (vomiting)). Known allergies: no. The patient's concomitant medications were not reported. After testing positive in mid December to COVID and being declared Covid free on 30Dec by the nursing staff and in good health, with normal vitals and oxygen levels, the patient was given a vaccination on 02Jan2021. In the early evening the patient's blood pressure dropped to 70/40 and the reporter was told to come for a last visit. The patient was sleeping comfortably. She did not wake up when spoke with her. No one expected her to make it through the night. The next morning she work up, ate breakfast, watched TV, got IVs and oxygen and her vitals improved significantly. Lab tests and procedures included blood pressure: 70/40 on 02Jan2021, oxygen levels: normal, COVID test: positive in Dec2020 (testing positive in mid December to COVID and being declare Covid free on 30Dec), vitals: normal; improved significantly. Facility where the most recent COVID-19 vaccine was administered: Nursing Home/Senior Living Facility. If the patient received any other vaccines within 4 weeks prior to the COVID vaccine: No. Prior to vaccination, was the patient diagnosed with COVID-19: Yes. Since the vaccination, has the patient been tested for COVID-19: No. AE resulted in: Life threatening illness (immediate risk of death from the event). Serious: Yes. Seriousness criteria-Results in death: No. Seriousness criteria-Life threatening: Yes. Seriousness criteria-Caused/prolonged hospitalization: No. Seriousness criteria-Disabling/Incapacitating: No. Seriousness criteria-Congenital anomaly/birth defect: No. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0940815
Sex: F
Age: 33
State: PA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: amoxicillin, keflex

Symptoms: Systemic: itching, swelling, pain, redness of left hand (received vaccine in left arm); symptoms lasted 0 days

Other Meds:

Current Illness:

ID: 0940816
Sex: F
Age: 64
State: CA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Numbness of tongue, change in taste, congestion, body aches, diarrhea, cough

Other Meds:

Current Illness:

ID: 0940819
Sex: F
Age:
State: KS

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: dizzy; itchy throat; coughing; swollen throat; This is a spontaneous report from a contactable pharmacist. A 21-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EL0142, NDC number: 59267-1000-1; Expiry Date: Mar2021), via an unspecified route of administration on 07Jan2021 11:20 at 0.3 mL, single at left arm for vaccination. Medical history included Cushing's disease (recovering), bipolar disorder from an unknown date and unknown if ongoing. Concomitant medication included lamotrigine (LAMICTAL) for bipolar disorder. On 07Jan2021, looked like after receiving the vaccine about 30 minutes later patient was standing and felt like dizzy. About 15 or 20 more minutes, or 45-50 minutes after received injection, she felt like itchy throat, then itchy throat triggered coughing, then she felt like swollen throat. For the treatment on scene patient was administered 50mg of diphenhydramine hydrochloride (BENADRYL) and when she complained of swollen throat was administered epinephrine (EPI-PEN) 0.3mg injection to right thigh. Then they called EMS who transported her to the hospital where she was admitted to the hospital. Outcome of events was unknown. This report was considered as serious per caused/prolonged hospitalization. Causality: Cannot jump to that conclusion.; Sender's Comments: Based on temporal association, the causal relationship between bnt162b2 and the events dizziness, throat irritation, cough and pharyngeal swelling cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees, and Investigators, as appropriate.

Other Meds: LAMICTAL

Current Illness:

ID: 0940820
Sex: F
Age:
State: ME

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: horrible body aches; Nausea; head fogginess; felt like a lump and couldn't move; not wanting to eat; This is a spontaneous report from a contactable nurse (patient). A 63-year-old female patient received BNT162B2 (Batch/lot number: E10140) first dose on 28Dec2020 11:15AM in the right arm at single dose since she is front line health care worker. Medical history included pain. Medical history included tramadol for pain. No Prior Vaccinations (within 4 weeks). Family Medical History Relevant to AE was none. She received the vaccine 28Dec2020 and it flattened her for two days. Her primary care provided has advised her not to take the next dose. Within 45 minutes she noticed nausea. She was eating lunch and she felt like everything was coming up and she forced herself not to vomit. The she noticed horrible body aches; head was foggy; she felt like a lump and couldn't move;. The body aches hurt in her arms, legs, hips, and back. Adds she was out of work for two days. She could feel it working as the symptoms would peak and then drop. She did go back to work but shouldn't have as she continued to feel nauseous and not wanting to eat. All of these symptoms have now resolved. Vaccination Facility Type was nursing home. No Vaccine Administered at Military Facility. Facility Name: Nursing Home. History of all previous immunization with the Pfizer vaccine considered as suspect was none. Additional Vaccines Administered on Same Date of the Pfizer Suspect was none. Event not resulted in Physician office or ER. The outcome of the event nausea was recovered on 02Jan2021. The outcome of event not wanting to eat recovered on 03Jan2021. The outcome of other events was recovered on 01Jan2021. The seriousness criteria for event horrible body aches was reported as medical significant.; Sender's Comments: The patient had medical history included pain. A possible contribution role of the first dose of BNT162B2 to the horrible body aches cannot be excluded. The case will be reassessed should additional information become available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0940821
Sex: F
Age: 44
State: ID

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Sodium low at 133, chloride low at 97, CO2 low at 22. All other labs and UA WNL. CXR WNL without evidence of acute cardiopulmonary process. EKG with sinus tachycardia, but otherwise normal study.

Allergies:

Symptoms: Patient, a 44 year old female received Moderna vaccine in L deltoid on 1/5/2021. On 1/6/2021, pt reported to vaccine clinic at 1130 with c/o racing heart and nausea. VS obtained. EMS called and patient transported to ER. Macular rash noted on chest per ER report. During time at ER, pt given IV fluids and PO Tylenol 1,000mg. Pt discharged home in stable condition with recommended follow up with PCP.

Other Meds:

Current Illness:

Date Died: 01/08/2021

ID: 0940822
Sex: M
Age:
State: GA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient passed away after receiving the Covid vaccine; This is a spontaneous report from a contactable nurse. An 81-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), intramuscular into the right arm on 07Jan2021 at 0.3 mL, single for covid-19 immunization. There was no medical history and no concomitant medications. On 08Jan2021, the patient passed away after receiving the COVID vaccine. The patient died on 08Jan2021. An autopsy was not performed. Investigations indicate that unspecified labs were done, but nothing two weeks prior; no further details were provided. The patient received the first dose the day prior. The reporting nurse discussed it with the medical director, and he thought that he potentially passed away from the COVID vaccine. The relatedness of the event to the suspect vaccine was reported as related by the reporting nurse per The Agency. The batch/lot number for the vaccine, BNT162B2, was not provided and will be requested during follow-up .; Sender's Comments: Based on the limited information available, it is medically not possible to make meaningful causality assessment, it is unlikely the vaccine could have contributed to the death of the patient based on the known safety profile. However case will be reevaluated when additional information is received during the follow-up The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Stated that the patient passed away after receiving the Covid vaccine

Other Meds:

Current Illness:

ID: 0940823
Sex: F
Age: 36
State: TX

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body aches, chills, fever, fatigue. Treatment include Tylenol and Motrin. Fever resolved

Other Meds:

Current Illness:

ID: 0940827
Sex: F
Age: 31
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: Penicillin

Symptoms: Received 2nd dose of Covid vaccine yesterday. Woke up at 4AM with chills, a mild headache, and arm pain. Ibuprofen helped to relieve symptoms. Still feels chills, arm pain, and now fatigue.

Other Meds: Emgality

Current Illness: None

ID: 0940829
Sex: M
Age: 73
State: MA

Vax Date: 01/04/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Cipro Clindamycin

Symptoms: Moderna COVID-19 Vaccine On day 9 after the vaccine I have a 2 inch red rash at the injection site with slight pain. This is new as of today. No prior rash.

Other Meds: Eliquis 5 mg, twice daily, Vitamin D 2,000 iu daily, B12 50 mcg daily

Current Illness: None

ID: 0940830
Sex: F
Age: 48
State: MI

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: Cold Ultricaria

Symptoms: Approximately 6:00 pm on 1/11/21 began experiencing muscle aches and fatigue. On 1/12/21 these continued but became progressively worse with headache starting around noon. By 3;30 pm, symptoms were: fatigue, muscle pain, severe headache. Body chills around 6 pm and temperature at 7 pm was 100.5. By 6:00 am on 1/13, all symptoms resolved.

Other Meds: Wellbutrin XL 150 MG, Prozac 20 MG

Current Illness: None

ID: 0940831
Sex: F
Age: 31
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever,chills, body ache, headache, fatigue, near syncope

Other Meds:

Current Illness:

ID: 0940833
Sex: F
Age: 94
State: GA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: NONE

Allergies: Keflex-rash,--Nylon-rash,- Codeine- Sulfate GI--Adhesive tape-rash, Latex--rash- Forteo-- Felt sick---Benadry close throat up

Symptoms: experienced a sore throat, sore tongue, and very fatigued on Saturday after having

Other Meds: vitamin B-12 1 tablet once a day.

Current Illness: none

ID: 0940835
Sex: F
Age: 32
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: n/a

Allergies: NKDA

Symptoms: Within 10 minutes after vaccination was given, pt developed a hive reaction that started at the injection site and spread to top of chest and lower neck, continued to spread up 45 minute post vaccine. Pt was evaluated by NP - BP 134/89, pulse 90. (2) 25mg oral benedryl were administered & 1 claritin tab. At90 minute post vaccination, hives rash had resolved. No other S/sx were noted.

Other Meds: Zoloft, Neurontin, Inderal

Current Illness: None

ID: 0940837
Sex: F
Age: 31
State: RI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: Estimated due date: Unknown - around 08/15/2021 - 1st OB appt on 01/12/2021 - I started having a headache on Thursday and chills and I checked my temp and it was 100.1F I monitored it and it was slowly climbing up. It hit 100.4F and I went home and it was 100.8F around 5PM I took a gram of Tylenol and few hours later headache and fever resolved and I felt completed normal after that. Next day all was back to normal but my arms hurt a lot the next day.

Other Meds: Prenatal vitamins and calcium supplement

Current Illness: no

ID: 0940838
Sex: F
Age: 42
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None was done

Allergies: Nitroglycerin

Symptoms: 10 minutes after the shot was given, I suddenly felt my heart was racing and a tingling sensation started from my left arm and radiated to my whole body. The sensation was very intense it felt like my whole body was being paralyzed. I was fading out because of high heart rate. My heart rate was 160 and I heard someone said my blood pressure was high. I was transferred to the ER and given epinephrine, anti-histamine, steroids.

Other Meds: Omega 3, vitamin D

Current Illness: None

ID: 0940839
Sex: F
Age: 52
State: MD

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: seen at Occupational health on 1/13/2021.

Allergies: Latex

Symptoms: swelling and redness at the site with warmth to touch and red streaking starting . Soreness to left arm since 1/11/2021. Redness and swelling noted on 1/13/2021

Other Meds: HCTZ 25mg Lisinopril 20mg Synthroid 50 mcg

Current Illness: none

ID: 0940840
Sex: F
Age: 77
State: TN

Vax Date: 12/30/2020
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: pt had normal visit with her PCP, he advised to inform Health Dept of adverse reaction

Allergies: PCN, onions

Symptoms: pts deltoid noticed significant swelling 4x4 inches

Other Meds: xarelto

Current Illness:

ID: 0940842
Sex: F
Age: 52
State: PR

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: no

Allergies: Tequin

Symptoms: At the time of the vaccine administration there is a numb tongue, heavy trachea and a numb face. Used medication for asthma. Flovent inhaler for 5 times. Used xyzal 5mgs via oral. These medications are used by doctor's orders.

Other Meds:

Current Illness: no

ID: 0940844
Sex: F
Age: 31
State: ID

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swelling of wrist, hands and lips. Hives

Other Meds: See Attached Document

Current Illness:

ID: 0940847
Sex: F
Age: 17
State: NM

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 0940848
Sex: M
Age: 25
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Fatigue. Started all of a sudden. Went to sleep early and took a naproxen and it resolved.

Other Meds: None

Current Illness: None

ID: 0940849
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0940850
Sex: F
Age: 64
State: WI

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Administered EpiPen and was sent to ED for evaluation

Allergies: RituximabAnaphylaxis Ace InhibitorsOther (See Comments) Lipitor [Atorvastatin] Sulfa (Sulfonamide Antibiotics)Rash

Symptoms: Immediately felt "strange" after receiving the vaccination. Developed hypertension, muscle aches, extremity swelling.

Other Meds: (very important) New medications from outside sources are available for reconciliation aspirin 81 mg Tab Take 2,000 Units by mouth daily. diclofenac (VOLTAREN) 1 % gel Take 1 capsule by mouth Daily. meloxicam (MOBIC) 7.5 MG tablet

Current Illness: None

ID: 0940851
Sex: F
Age: 37
State: AL

Vax Date: 12/31/2020
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: pink skin around injection site approximately 2 inches in diameter, soft, mild warmness.

Other Meds: trulicity, lipitor, famotidine, multi-vitamin, collagen

Current Illness: No

ID: 0940852
Sex: F
Age: 31
State: FL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: Vitals (Temperature, Pulse, BP, SPO2) 1/12/21 Lab tests completed: CBC w/ Platelets 1/12/21

Allergies: No known allergies

Symptoms: Patient had sudden onset of flushing/erythema of skin (no pruritus, but warm to touch), diaphoresis, and itchy throat. She denies shortness of breath or any respiratory problems. Symptoms started 20 min prior to arrival at the Emergency Department. When the patient arrived at the ED, all of her signs and symptoms had started to subside.

Other Meds: Unknown

Current Illness: Unknown

Date Died: 01/12/2021

ID: 0940855
Sex: F
Age: 79
State: AR

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: Patient received her vaccination on 1/12/21 administered by pharmacy*+. She expired on 1/12/21 an approximately 7:30pm. Resident did not have any adverse reactions and was a hospice patient.

Other Meds: LORazepam Solution 2 MG/ML

Current Illness: Resident was a hospice patient but POA requested that she get the vaccination. Resident was already near end of life and the vaccine may not have had anything to do with her death.

ID: 0940856
Sex: M
Age: 29
State: PA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: blood sugar

Allergies: n/a

Symptoms: Pt received COVID19 Vaccine (Moderna) at 9am 1/8/2021. -Pt completed 15 min observation and then returned to work. -Pt came back at 12:30 with the following symptoms: stomach pain, nausea, shivering, feeling very cold, headache, "sleepiness" of his left arm (same arm as the shot), itchy throat, cough, and feeling very thirsty. -Pt reports his headache as very painful, b/l, and feeling as if his head was very "hot." Pt has no hx of headaches. -Nausea in and out, never vomited. -Denied dizziness, change in vision, shortness of breath, difficulty breathing, chest pain, difficulty swallowing, rash, lightheadedness. -Pt did not eat anything all morning. -Took vitals, blood glucose (see vitals section). High BP and pulse. Sugar: 169 -Pt given Benadryl 25mg IM (on opposite side of vaccine). -Pt took 500mg Tylenol and then a few hours later 500mg more Tylenol (on own accord). -Pt observed 12:30-4:30. Slept off and on. Felt a lot better at 4:30. Pt discharged. -Pt was also seen and evaluated by MD. -Of note, pt does not have any allergies that he is aware of. -Has "pre HTN and pre diabetes." -Hx of heart disease - father CABG, in mid 40s. -Pt was observed for 4 hours. -BP went down after pt calmed down a little bit and was given Benadryl and Tylenol. -Pulse was also very high, but then decreased throughout observation (see VITALS section). -Pt feeling fine at 4:30 and discharged.

Other Meds: metformin omeprazole

Current Illness: n/a

ID: 0940857
Sex: F
Age: 73
State: MI

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Sulfa drugs, tylenol #3

Symptoms: Vomiting, diarrhea

Other Meds:

Current Illness:

ID: 0940859
Sex: F
Age: 40
State: CA

Vax Date: 12/24/2020
Onset Date: 12/24/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: 12/29/2020 CBC w/ Auto Diff- WBC 10.1 RBC3.5 HGB 9.5 HCT 31.3 MCV 88.7 PLTS 264 others available if needed US Venous Doppler- Negative for DVT, Non specific enlarged Left inguinal Lymph node measuring 2.8x0.4x1.5cm

Allergies: pineapple, kiwi sensitivity. (itching)

Symptoms: ?Pfizer-BioNTech COVID-19 Vaccine EUA. My Left Leg (entire leg) was swollen & Numb) I received my vaccine and when I arrived home about 1pm that day My leg felt odd. when walking, standing I felt an odd sensation in my left foot/lower calf area. I had body aches mild which progressed at night especially pain running down my left side of my body. The next morning I put on my clothes for work and my body still mild aches but the pant leg was tight especially around the calf. My My left foot was swollen as well as my shoe fit tighter. I also had a numbing sensation through the leg. I had an ache behind the calf and the heel of my foot as well as the left foot of my left foot. The swelling remained and I worried I might have a DVT. I called my primary care DR office and they said I should go to the ER. I called employee health at my job and they told me go to the ER. So on 12/29/2020 I went to the ER. The providers there also thought I had a DVT especially after examining my leg and recognizing the significant swelling. My US venous doppler showed negative for DVT however a significantly enlarged lymph node. As of today the swelling is much improved however still slight. The sensation in my left foot is still not the same as before. I have a numbness and tingling sensation that runs from my Left lateral calf down to the sole of my foot.

Other Meds: none

Current Illness: none

ID: 0940860
Sex: F
Age: 26
State: ME

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: na

Allergies: Amoxicillin, Penicillin and bee stings

Symptoms: Within fifteen minutes of the vaccine became itchy all over and pharmacy administered Benadryl. This morning she developed a temp of 99.4, shaking all over, chest hurts, cough and aching

Other Meds: Symbicort two puffs, bid Proventil rescue inhaler

Current Illness: no

ID: 0940861
Sex: F
Age: 24
State: CT

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Discomfort and pain associated with a soft, swollen, tender lump with no erythema located under the left ventral supraclavicular skin.

Other Meds: Spironolactone 25mg tablet po qd Sertraline 50mg tablet po qd Vit D 1000 unit capsule po qd Loratidine 25mg tablet po qd Women's daily multivitamin

Current Illness:

ID: 0940862
Sex: M
Age: 45
State: WI

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: seasonal

Symptoms: Patient with significant erythematous reaction to left deltoid ~ 13x20 cm in size. Progressively increasing in size. Tx for concern of cellulitis vs. localized reaction due to Prevnar 13.

Other Meds: none

Current Illness: None

ID: 0940864
Sex: M
Age: 0
State: AL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Patient four months old, kinrix was given inadvertently. Medication error

Other Meds: N/A

Current Illness: N/A

Date Died: 01/09/2021

ID: 0940866
Sex: M
Age: 75
State: SC

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Loxapine, Thioridazine

Symptoms: Patient was found "acting abnormal" on 1/9/2021 at 1215. VS HR 20-30's. EMS activated. EMS arrived and patient was found pulseless in PEA/ asystole, CPR and ACLS initiated and then transported to the MC. Unsuccessful resuscitation and expired on 1/09/2021 at 1348. Clinical impression Cardiopulmonary arrest.

Other Meds: Amlodipine, ASA, Atorvastatin, Baclofen, Risperidone, Levothyr

Current Illness: None

ID: 0940868
Sex: M
Age: 46
State: NJ

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 2 hours post injection patient vocalized lower abdominal discomfort accompanied by multiple episodes of diarrhea following day diarrhea subsides but patient notes lethargy, blurred vision, chills/fever (max 102) and itchy, tender, red induration to left deltoid at injection site. Induration has enlarged to current 11cmx9cm in size. Area marked for monitoring

Other Meds: None

Current Illness: None

ID: 0940871
Sex: F
Age: 41
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: ibruprofen, morphine, minocycline

Symptoms: 2 dose, feeling of being cold, not able to warm up, unable to sleep

Other Meds:

Current Illness:

ID: 0940873
Sex: M
Age: 54
State: PA

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Recipient reported sudden worsening of urinary retention following the 1st dose of Covid19 vaccine. The symptoms did resolve within 24 hours and did not reoccur with the second dose administration.

Other Meds: Tamulosin and Finasteride

Current Illness: BPH

ID: 0940874
Sex: M
Age: 52
State: IN

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: The day after receiving my 2nd COVID shot I had experienced whole body aches for a period of approximately 12-14 hours

Other Meds: metoprolol succinate 1- 25 mg tab daily ezetimibe/ simvastatin 1- 10-20 tab daily montelukast sodium 1 10 mg tab daily

Current Illness: None

ID: 0940877
Sex: F
Age: 64
State: PR

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: NONE

Allergies: NONE

Symptoms: PAIN INJECTION SITE,TIRE,MUSCULAR PAIN,JOINT PAIN,COUGH AND TARDICARDIAC.

Other Meds: NONE

Current Illness: NONE

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm